Feline stomatitis is an inflammatory disease that causes severe tissue changes around the gums of the teeth and back of the mouth. The condition can occur at any age in cats and is only treatable with dental cleanings, tooth extraction, antiinflammatory drugs, and laser surgical reduction of the inflamed tissues.The presenting complaints for cats with feline stomatitis include, growling, pawing at the mouth, drooling, pain and hissing when eating, yowling, and weight loss. Sometimes too the cat presents for not being able to close it's mouth because a tooth has become loose and is wedging the cat's mouth open. The physical exam is usually diagnostic as the characteristic tissue changes, called faucitis, from all the inflammation at the back of the mouth, is very obvious, as in the pictures above. Biopsy and histological analysis is not often done, but when it is, lymphocytic and plasmacytic cells dominate the cellular structures.
The cause of the disease is a combination of gingival immune reaction to the dental plaque, and quasi-autoimmune response to the actual dental tissues themselves. The cat is essentially allergic to it's own teeth, as evidenced by dental erosions at the sulcus line, and eventual tooth loss, if the condition is left untreated. It is worth noting here that cats have a very strange immune system and are plagued by various diseases where the immune system cells go rogue in the body and form tumors, like lymphomas, eosinophilic lesions like rodent ulcers in the lips, and other autoimmune type diseases like oral stomatitis. It has never ceased to amaze me how independently the immune system can function. To form tumors, cancers, and inflammatory responses to the bodies own healthy tissues, says the immune system may well have a mind of it's own.
Treatment of the disease is by client and veterinarian choice. The least destructive treatments include frequent dental cleanings, and oral predisone administration. More aggressive treatments include dental extraction and laser ablation of the affected and inflamed tissues. I have used all the methods listed here for treatment, but my approach is to use the gentle and conservative treatments unless more aggressive therapy is absolutely needed. Monthly injections of Depo-Medrol, a long-acting injectable version of prednisilone, and even gold injections work well to control chronic plasmacytic-lymphocytic gingivitis and stomatitis. The gold injections though, which are also used to treat chronic arthritis in people, come with some odd side effects like a general loosening of the cats connective tissues in it's joints and skin.
Feline stomatitis is only treated and not cured, though some vets tout that complete dental extraction of all the cat's teeth is a cure, since that does end the stomatitis response. Losing all the teeth, I would say is a treatment, because it is a permanent change to the normal anatomy, and though it ends the disease, it also ends the dentition.
Many Thanks go out to Jaya and her cat Gamma for their suggestion of this article.
Dr. Doug Ikeler http://www.ikelerbooks.com/
Thanks for this article. I may have to ask my vet about those Depo-Medrol shots you mentioned. Gamma sends her regards to you as well.
ReplyDeleteWhen teeth become lose and interfere with the mouth closing, will they fall out themselves or should a vet remove them in a clinic. My cat has this issue today and Im not sure what to do. Or how to follow up. She has Depo shots every two months
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